scholarly journals Comparison of the Effects of Target-Controlled Propofol Infusion and General Anesthesia with Isoflurane on Postoperative Cognitive Functions in Controlled Hypotensive Anesthesia

2021 ◽  
Keyword(s):  
General Anesthesia ◽  
Cognitive Functions ◽  
Hypotensive Anesthesia

scholarly journals Effect of regional anesthesia as a component of multimodal pain relief on the cognitive status of patients in ophthalmic surgery

2021 ◽  
Vol 15 (1) ◽  
pp. 49-56
Author(s):  
Ganna S. Dorofeeva ◽  
Yuriy Yu. Kobelyatskyy
Keyword(s):  
General Anesthesia ◽  
Regional Anesthesia ◽  
Postoperative Period ◽  
Cognitive Functions ◽  
Gas Flow ◽  
Initial Level ◽  
Cognitive Status ◽  
Ophthalmic Surgery ◽  
Group B ◽  
Group D

This article examines and analyzes the dependence of the state of the central nervous system (CNS) in the postoperative period in patients who underwent penetrating keratoplasty. MATERIAL AND METHODS: The analysis of cognitive status was performed using neuropsychological testing involving the scale of frontal dysfunctions (Frontal Assessment BatteryFAB) and a short scale for assessing mental status (Mini-Mental State ExaminationMMSE). The results were assessed on the eve of the operation, 6 h after the operation, and 7 and 21 days after the operation. Depending on the applied method of anesthesia, several groups were identified. In group d, general anesthesia (OA) was used with dexmedetomidine infusion 40 min before surgery. In group b (before surgery), a wing-palatine fossa block was performed 20 min, in addition to general anesthesia. Anesthesia was maintained with sevofluraneoxygen mixture at a low gas flow. The groups were statistically comparable in terms of age and gender. The depth of anesthesia and sedation was assessed using the bispectral index and analgesia nociception index, respectively. RESULTS: According to the results of testing on the MMSE and FAB scales, the cognitive indicators in the first 6 h after surgery were higher in group d than in group b. However, by day 21, these indicators differed slightly (p 0.05). Thus, the following tendencies were observed in group b 6 h after the operation: a decrease in indicators on the MMSE scale by 20.8% and on the FAB scale by 28.6% from the initial level. For group d, the indicators on the MMSE scale were reduced by 8.3%, and those on the FAB scale were reduced by 13.3% at the same stage of the study. When testing on the same scales 21 days after surgery, the indicators of cognitive functions were restored to the initial level in both groups. CONCLUSION: The levels of cognitive functions of ophthalmic surgical patients after surgery involving regional anesthesia and dexmedetomidine differed significantly in the first hours of the postoperative period. After 21 days, the neuropsychological status did not differ significantly (p 0.05).

scholarly journals Influence of general anesthesia for tonsillotomy and adenotomy to cognitive functions in children

2021 ◽  
Vol 10 (2) ◽  
pp. 173-182
Author(s):  
Lyubov’ S. Zolotareva ◽  
Oleg N. Paponov ◽  
Sergeу M. Stepanenko ◽  
Ekaterina V. Silina ◽  
Aleksandra V. Adler
Keyword(s):  
General Anesthesia ◽  
Cognitive Functions ◽  
Neuropsychological Testing ◽  
Clinical Manifestations ◽  
Test Results ◽  
Surgical Interventions ◽  
Balanced Anesthesia ◽  
Clinically Significant ◽  
Mechanical Memory ◽  
State Examination

Background. Surgery under general anesthesia can affect the patients neurocognitive outcome. This problem is of particular relevance in pediatric surgical practice. Goal. The aim of this study is to determine the spectrum of clinical manifestations and the frequency of cognitive dysfunction symptom development in children after adenotomy and/or tonsillotomy performed under general anesthesia. Methods. This prospective study included 30 children aged 3 7 years (average age 4.9 1.3 years) who underwent adenotomy and/or tonsillotomy under general, combined, balanced anesthesia. In the preoperative period and a day after the operation, neuropsychological testing was performed: The Raven test, mechanical and associative memory test, Mini-Mental State Examination (MMSE) scale adapted for children from 3 years old, and the Bourdon test. A 20% decrease in function compared with the initial level was considered clinically significant. Results. One day after surgery, 10% of patients had a clinically significant decrease in attention productivity, 10% had a decrease in attention accuracy, 13.3% had a decrease in attention index, and 16.7% had a decrease in overall productivity and the attention index according to the Bourdon test. Also, 13.3% showed a decrease in attention, 30% had a decrease in memory on the MMSE scale, 20% showed a decrease in mechanical memory, and 10% had a decrease in test results on the Raven test. Conclusion. Conducting even minor surgical interventions with general anesthesia leads to an impairment of various cognitive functions in 10%30% of children aged 3 to 7 years.

scholarly journals Controlled hypotensive anesthesia in the beach-chair position under general anesthesia: Is it safe for shoulder arthroscopy?

2020 ◽  
Vol 62 (2) ◽  
pp. 109-113
Author(s):  
Mehmet Özgür Özhan ◽  
Mehmet Burak Eşkin ◽  
Ceyda Çaparlar ◽  
Mehmet Anıl Süzer ◽  
Uğur Gönç ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Shoulder Arthroscopy ◽  
Hypotensive Anesthesia ◽  
Beach Chair Position ◽  
Beach Chair

scholarly journals Effects of Combined and General Anesthesia on Cognitive Functions for Patients Undergoing Cardiac Surgery Under CPB

2021 ◽  
Vol 24 (4) ◽  
pp. E593-E597
Author(s):  
Greta Kasputytė ◽  
Rasa Bukauskienė ◽  
Edmundas Širvinskas ◽  
Tadas Lenkutis ◽  
Renata Vimantaitė ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cardiac Surgery ◽  
Cognitive Function ◽  
General Anesthesia ◽  
Cognitive Functions ◽  
Test Results ◽  
The Central Nervous System ◽  
Combined Anesthesia ◽  
Function Assessment

Background: Patients may experience a variety of neurological complications after heart surgery. The most common complication observed in clinical practice is delayed neurocognitive recovery (dNCR). The role of the anesthesiologist is very important, as the risk of dNCR may be reduced, depending on the anesthesia tactic chosen. Although the possibility that neuropsychological complications are less common in patients undergoing combined anesthesia (general + epidural) than in patients undergoing general anesthesia is not yet confirmed, the results are being discussed. The aim of this study was to determine impact of combined anesthesia (general + epidural) on cognitive functions of patients after cardiac surgery. Methods: The prospective, case-controlled study included 80 patients undergoing cardiac surgery from 2015 to 2017 at the Department of Cardiothoracic and Vascular Surgery in the Hospital of Lithuanian University of Health Sciences Kauno Klinikos. After approval from the local bioethics center, informed consent was obtained from all study participants. Inclusion criteria were age 51 to 80 years, elective cardiac surgery, left ventricular ejection fraction > 35%, anamnesis of not using agents affecting the central nervous system, absence of neuropathology, and sufficient renal function. Exclusion criteria were patients suffering from diseases causing cognitive function or using agents affecting the central nervous system, emergency or re-surgery, carotid artery atherosclerosis with artery diameter 50 or more percent reduction, and a patient’s disagreement. MMSE test and 6-CIT test were used for a cognitive function assessment, Trail making test and WAIS Digital Symbol Substitution test were used for psychomotor function assessment. All tests were used a day before surgery and seven days after surgery. According to the planned anesthesia, patients were assigned into two groups: 1 – combined general + epidural anesthesia and 2 – general anesthesia. Standardized protocol of anesthesia was followed for all patients. Preoperative patients and surgery factors, preoperative and postoperative neuropsychological test results were recorded. Results: Eighty patients were enrolled in the study. Both groups did not differ in demographic, perioperative values, and baseline (preoperative) test results. Postoperative (7th day) WAIS (P = .042) and 6-item cognitive impairment (P = .016) test results were statistically different when comparing the GA and CA groups. Comparing preoperative and postoperative test results, there was a significant decline in the WAIS test score in the GA group (P = .013).

scholarly journals Hypotensive Anesthesia with Propofol Infusion Pump: A Boon for Endoscopic Sinus and Nasal Polyps Surgery

2011 ◽  
Vol 4 (1) ◽  
pp. 5-8
Author(s):  
Sudhir M Naik ◽  
Sarika S Naik
Keyword(s):  
Blood Loss ◽  
General Anesthesia ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Sinus Surgery ◽  
Successful Outcome ◽  
Anesthetic Techniques ◽  
Operative Field ◽  
Hypotensive Anesthesia ◽  
Duration Of Surgery

ABSTRACT Background Successful outcome of endoscopic sinus surgery depends on complete visualization of the operative field and intraoperative control of bleeding. Major disadvantage of general anesthesia is the increased bleeding encountered, which can interfere with optimum visualization of the intranasal anatomy unless hypotensive methods are used. Objectives To study the different anesthetic techniques in relation to their impact on blood loss and duration of surgery. The role of propofol was also evaluated. Design Department of Anesthesia and ENT, Head and Neck Surgery, KVG Medical College and Hospital, Sullia, Karnataka, India. Materials and methods 213 cases of endoscopic sinus surgeries done for nasal polyposis, sinusitis, dacryocystitis and septorhinoplasties under local and general anesthesia were evaluated between June 2009 and August 2010. Result A good operative field was seen with propofol anesthesia compared to halothane anesthesia. The problems of fogging and frequent suctioning were lesser with propofol hypotensive anesthesia. Conclusion Hypotensive anesthesia using propofol infusion is the anesthesia of choice for extensive nasal polyposis. Propofol when used both for induction as well as maintenance of general anesthesia in endoscopic sinus surgeries significantly reduces the blood loss, thereby improving the visibility of the endonasal structures and minimizes the chance of complications related to endoscopic sinus surgery.

Prevention of cognitive disorders in the postoperative period in preschoolers

2020 ◽  
Vol 15 (4) ◽  
pp. 92-99
Author(s):  
L.S. Zolotareva ◽  
◽  
O.N. Paponov ◽  
S.M. Stepanenko ◽  
A.V. Adler ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Postoperative Period ◽  
Cognitive Functions ◽  
Postoperative Cognitive Dysfunction ◽  
Cognitive Disorders ◽  
Cognitive Outcomes ◽  
Control Group ◽  
Balanced Anesthesia ◽  
Key Words Anesthesia ◽  
Experimental Group

Surgeries under general anesthesia may result in reduced cognitive functions in children, which is important for child development Objective. To assess the incidence of cognitive disorders in children aged 3 to 7 years after intraoperative combined balanced anesthesia and to evaluate the efficacy of Cytoflavin in preventing them. Patients and methods. This study included 85 children who had undergone surgery (adenoidectomy and/or tonsillectomy) under general combined balanced anesthesia (sevoflurane, nitrous oxide, rocuronium bromide, fentanyl, and dexamethasone). The patients were randomized into two groups: control group (n = 40) and experimental group, in which children additionally received one infusion of cytoflavin intraoperatively (n = 44). All patients underwent comprehensive testing with the assessment of various cognitive functions before surgery, 24 hours postoperatively, and one month postoperatively. Results. Cognitive disorders were observed in 6%–10% of children after general anesthesia. The main manifestations of cognitive deficits in the postoperative period, such as impaired concentration, were most significant 24 hours postoperatively, but were eliminated one month later. A total of 7.1% of children demonstrated at least 20% decrease of their attention after surgery under general balanced anesthesia (confirmed by at least 3 tests). Six percent of children had a 20% decrease in their memory 24 hours postoperatively (confirmed by 2 tests). Cytoflavin improved cognitive performance 24 hours postoperatively, while patients in the control group had no significant changes. However, administration of cytoflavin had no significant impact on the incidence of cognitive deficit. Further studies are needed to identify children at risk who require prevention of cognitive disorders associated with anesthesia. Key words: anesthesia in children, anesthetics, pediatric surgery, cognitive outcomes, nicotinamide, postoperative cognitive dysfunction, cytoflavin

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